Knee pain can be frustrating and uncomfortable at any time, but why does it feel so much worse at night? There are many different answers to this question, ranging from genetics to sleeping positions to obesity. In our post, we talk about the many different causes of knee pain so you can find the right treatment for your discomfort and start sleeping better.

Common Causes of Knee Pain at Night

Twenty-five percent of adults suffer from frequent knee pain, check out the list below to find out why you may be part of that percentage.


There are tons of different kinds of arthritis, but below are the types of arthritis that most commonly cause knee pain.

  • Knee osteoarthritis is the most common cause of knee pain at night for people over the age of 50. Osteoarthritis causes cartilage damage when your joints get worn down, and it can be genetic.
  • Gout is a type of arthritis that causes redness and tenderness in your joints. Inflammation and swelling are common when dealing with gout, and they occur mostly at night.
  • Rheumatoid arthritis could also be the cause of your knee pain since it causes antibodies to attack the tissue around your joints.
  • Post-traumatic arthritis is when damage is still occurring long after a knee injury. This breaks down the cartilage between your bones, causing knee and joint pain even after you have healed.

Low Cortisol Levels

Cortisol is a natural hormone in your body that helps fight inflammation. Cortisol levels are naturally lower at night, which can cause your knee to feel inflamed, and thus more painful than it did during the day.

Pain Perception

Our perception of pain changes throughout the day and our pain tolerance is at its lowest at night. So, what may not have bothered you throughout the day, now feels more painful at night.

Lack of Distractions

During the day, we are often distracted by things like work, cleaning, cooking and eating, and other people we interact with. At nighttime, those distractions are gone.

When your mind is distracted, it can’t focus on the pain, but when the distractions are gone, the pain becomes more noticeable. A lack of distractions could be the reason your knee hurts more at night than it does during the day.


Some health conditions can cause excessive knee pain at night, but the most common is knee bursitis. There are cushions in between your joints and muscles, but bursitis causes those cushions to become inflamed.

Bursitis can occur anywhere but is most common in knees because of the repetitive motion of knee joints. Tendonitis causes inflammation in your tendons, and can also be a cause of nighttime knee pain.

Less Movement

Staying in one sleeping position for too long can cause your knee and joints to feel stiff. Rotating your sleeping position a few times throughout the night can ensure your knee won’t get stiff and achy.

Tips to Alleviate Knee Pain

But with all the many causes, comes many solutions as well. While some knee pain may need medication or surgery to fix, there are other treatments you can try, such as using heat therapy or changing your shoes.


RICE stands for Rest, Ice, Compress, and Elevate. This is a common treatment plan that can easily be done at home. Your knee is always working which can cause overuse, give it a break and allow it time to heal. Ice is anti-inflammatory and can subside feelings of pain, but don’t use ice for longer than 20 minutes.

Using a wrap or brace to compress your knee can prevent fluid build-up that causes swelling, and it gives your knee added support. Elevate your knee on a pillow or in a recliner to help reduce swelling before you go to bed.

Use Heat

Alternating between heat and ice therapy can help relieve knee pain. A warm water bottle or heating pack on your knee is perfect for a few minutes before bedtime, or if you have more time, a warm bath can also help your knee feel better.

Take Ibuprofen

If all else fails, over-the-counter pain medication is an option, although it’s not a long-term solution. If your knee pain only comes around occasionally, ibuprofen might be a quick and easy fix. Topical analgesics like joint creams, gels, and patches can also be helpful pain relievers.

Distract Yourself

Knee pain can get worse at night because there is nothing to distract you from the discomfort, but creating your own distractions can help alleviate some of that irritation.

For example, focusing on your breathing or imagining relaxing scenarios can keep your mind off the pain until you fall asleep.

Try Physical Therapy

Physical therapy will help your knee heal faster, and strengthen it in the process. Strengthening the muscles around your knee will help reduce pain and make your knee stable.

Wear Comfortable Shoes

Supportive shoes can make a huge difference when it comes to knee pain because it relieves some of the pressure on your knees, allowing them to rest.

A high-quality mattress can also help your knee feel better by providing cushion and support to alleviate weight and pressure. Additionally, using a supportive memory foam pillow between your legs or under your knees will also reduce the stress placed on your knees.

Exercise Regularly

Exercise is proven time and time again to be beneficial for your body, and that includes your knees. When you exercise and lose weight, you can strengthen your knees and reduce the strain placed on your joints. For more immediate relief, try stretching your hips before bed as this could help reduce pressure on your knees.

Additionally, regular exercise promotes a healthy sleep schedule, making it easy for you to fall asleep at the same time each night.

Common Questions

Is it OK to wear knee support all day?

Yes, it is OK to wear a supportive knee brace all day, especially if you’re participating in activities or sports. However, you should not wear knee supports at night because you need to let your knee relax and remove the compression wrap or brace to let it breathe.

How do you fall asleep when you’re in pain?

Practicing preventative methods, like wearing a knee brace or icing your knee, is the best way to make sure you won’t experience knee pain at night. However, relaxation techniques can help fall asleep quickly even if your need is hurting. Focusing on your breathing can help distract you from the pain.

Take long, deep breaths and think of fun stories or relaxing scenes to distract you until you fall asleep. The next day, you should give your knee a rest and try heat and ice therapy.

How should you sleep with bad knees?

An added pillow can be really helpful if you suffer from knee pain. If you sleep on your side, place the pillow between your knees to give them that extra support and cushion. If you sleep on your back, place the pillow underneath the bend in your knees so there is a slight elevation to alleviate pressure.

How long does it take for knee pain to go away?

How long your knee pain lasts depends on what is causing it. For example, arthritis is a chronic condition meaning your knee pain could last years, while a small knee sprain may only last a few weeks. The more you take care of your knees and joints, the better they will feel.

When should I worry about knee pain?

Occasional knee pain because of extraneous activities, such as running or exercising, is common and completely normal, but you should talk to your doctor if your knee pain is consistent and doesn’t go away after a few days. Before worrying too much about your knee pain, try some different treatments to see if anything changes, like using heat before bed or changing your shoes to a pair more supportive.


Knee pain at night can be caused by many different things, but there are lots of ways to treat it. Being preemptive is a great way to avoid knee pain altogether, such as wearing supportive shoes or exercising on a regular basis. However, there are ways to treat preexisting knee pain as well, such as using heat or practicing physical therapy. Regardless of what may be causing your knee pain, there are ways to treat it so you can relax, feel better, and get a good night’s sleep.

This article is for informational purposes and should not replace advice from your doctor or other medical professional.